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HIV感染患者中不构成艾滋病定义的细菌感染

Non-AIDS defining bacterial infections in patients with HIV infection.

作者信息

Skrzat-Klapaczyńska Agata, Kowalska Justyna D., Matłosz Bartłomiej, Bednarska Agnieszka, Paciorek Marcin, Horban Andrzej

机构信息

Medical University of Warsaw, Department for Adult’s Infectious Diseases, Warsaw, Poland

Hospital for Infectious Diseases, Warsaw, Poland

出版信息

Przegl Epidemiol. 2019;73(4):511-521. doi: 10.32394/pe.73.48.

Abstract

OBJECTIVES

The use of effective combinated antiretroviral therapy has significantly improved the prognosis of patients with HIV infection. Although current antiretroviral regimens are very effective in inhibiting viral replication, its elimination is not a viable goal of treatment. Despite cART, non–AIDS-defining bacterial infections are still a serious problem. The spectrum of these infections, and in particular the proportion of particular bacterial pathogens, is not sufficiently described in the scientific literature.

METHODS

In the study, HIV-infected patients followed at the HIV Out-Patient Clinic in Warsaw were registered in the clinic from 1 January 2007 to 31 July 2016. Survival analysis included 558 patients who met the study criteria.

RESULTS

Among 251 (44.9%) of those with positive culture, the most common bacterial pathogen was Staphylococcus aureus (33%) and Escherichia coli (11.1%). The most common bacteria in the upper respiratory tract was Staphylococcus aureus (26.6%). In urine cultures the most common bacteria was Escherichia coli (9.5%). Staphylococcus aureus (2.3%) and Staphylococcus epidermidis (2.3%) were the most common bacterial cultures in the wound. In skin cultures the most common bacteria was Staphylococcus aureus (3.9%). The highest number of positive cultures was obtained from the upper respiratory tract -166 (66.1%).

CONCLUSION

Non–AIDS-defining bacterial infections are a common clinical problem in HIV-infected patients despite the introduction of antiretroviral therapy and the pathogens that cause these infections are a very diverse group.

摘要

目的

使用有效的联合抗逆转录病毒疗法显著改善了HIV感染患者的预后。尽管目前的抗逆转录病毒方案在抑制病毒复制方面非常有效,但清除病毒并非可行的治疗目标。尽管有cART,但非艾滋病定义的细菌感染仍然是一个严重问题。科学文献中对这些感染的范围,特别是特定细菌病原体的比例描述不足。

方法

在该研究中,2007年1月1日至2016年7月31日在华沙HIV门诊随访的HIV感染患者在该门诊进行登记。生存分析纳入了558名符合研究标准的患者。

结果

在251例(44.9%)培养阳性患者中,最常见的细菌病原体是金黄色葡萄球菌(33%)和大肠杆菌(11.1%)。上呼吸道最常见的细菌是金黄色葡萄球菌(26.6%)。尿培养中最常见的细菌是大肠杆菌(9.5%)。伤口中最常见的细菌培养是金黄色葡萄球菌(2.3%)和表皮葡萄球菌(2.3%)。皮肤培养中最常见的细菌是金黄色葡萄球菌(3.9%)。培养阳性数量最多的是上呼吸道——166例(66.1%)。

结论

尽管引入了抗逆转录病毒疗法,但非艾滋病定义的细菌感染仍是HIV感染患者常见的临床问题,且引起这些感染的病原体种类繁多。

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